Systems and methods for inducing behavior change

ABSTRACT

Generally, described herein are computer-implemented systems and methods for self-guided education in various aspects of health care. The described systems and methods effect behavior change through a functional relationship between the content of educational case packages comprising a plurality of displays, each of which has one or more completion conditions which must be completed by the user in accordance with a health care procedure to be practiced. The performance of the case by the user habituates behavior change through practice of a health care procedure.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. Non-Provisional patentapplication Ser. No. 15/712,790 filed Sep. 22, 2017, which claimsbenefit of U.S. Provisional Patent Application No. 62/398,165 filed Sep.22, 2016, the entirety of which is incorporated herein by reference.

BACKGROUND OF THE INVENTION Field of the Invention

This disclosure pertains to the field of health care, and particularlyto automated computer systems for inducing desired health care practicesin a user.

Description of the Related Art

The old saw “practice makes perfect” has persisted for the simple reasonthat it is true. Study after study has shown that humans, like mostanimals, are creatures of habit, and generally learn best by doing. Thisbasic concept is well known to any educator, as hours of lecture andexplanation are no substitute for the pupil simply practicing the skillbeing taught.

This applies equally to health education. Poor health practices imposean enormous cost on society. Simple practices like hand sanitization caninhibit the spread of disease, sparing workers and employers downtimefor illness, which imposes a massive cost on society. Although theInternet has made available high quality information concerning goodhealth practices, users still must to know that such information exists,and seek it out and use it, in order to benefit from it. This aloneprevents many people who would benefit from access to such informationfrom ever encountering it. Moreover, even people who do see theinformation may not necessarily act on it.

Improving health care practices via behavior change is increasingly atthe heart of health care. Whereas in generations past, health care wasprovided in a reactive model of diagnosing and treating acute disease,the focus is shifting to proactive healthcare based on preventing acutedisease and efficiently managing chronic illness. With health care costsrapidly rising into the trillions of dollars in the United States alone,innovation is needed. According to one study, more than thirty percentof health care costs can be directly attributed to behaviorallyinfluenced conditions, and almost seventy percent of total costs areheavily influenced by patient behaviors. Such behaviors range frompharmaceutical non-compliance to skipping therapies to not sanitizingone's hands after petting a dog.

It was long believed that people fail to adopt disease preventionstrategies and submit to appropriate medical tests because they simplydid not believe that disease posed a realistic threat, particularly whenmeasured against the effectiveness of the preventive steps in question,and the cost (in terms of time, money, and hassle) in taking thosesteps. That is, a person's interest in avoiding illness is often tooabstract, remote, or speculative to overcome a simultaneously presentbias against changing behaviors, which is perceived by the patient asunlikely to be effective. However, this does not account for individualattitudes, beliefs, and other cognitive biases that influence behaviorand also does not account for non-clinical preventive behaviors thatinfluence health and disease.

Other behavioral models attempt to explain behaviors over which peoplehave the ability to exert self-control, but do not. For example, despitethe widespread availability of literature and messaging on the healthcomplications of smoking, people continue to smoke. The planned behaviormodel, for example, focuses on intent, taking into account bothmotivation and ability to engage in, change, or discontinue behavior.Influencing factors include individual attitudes, subjective beliefs andnorms, social norms, and perceived control. However, this model assumesthe individual has the resources to understand which behaviors to adoptor change, as well as the opportunity and support to be successful inmaking such behavior changes. Also, other factors strongly influencechoice in the moment, such as temporary emotional states, and theindividual's degree of actual conscious control over behavior, which isoften overestimated.

While these or other models have identified more than 400 barriers togeneral behavior change, there are five common reasons why peoplemaintain poor health habits: (1) treatment is not perceived as valuableor necessary; (2) treatment is not convenient; (3) treatment cost isperceived as far exceeding its value; (4) ancillary effects of treatmentare perceived as exceeding health benefits; and (5) the patient lackssufficient knowledge to motivate behavioral change.

Each behavioral change theory has benefits and shortcomings, and nosingle theory completely explains behavior. However, a few key issuesapply, regardless of the theory. First, if the patient does not haveaccess to health care education, the patient will not receiveinformation needed to set the groundwork for habituating good healthcare practices. Second, unstructured distribution of health careinformation can actually be counterproductive. For example, the Internetis both a blessing and curse, as the enormous volume of availableinformation can be overwhelming and present patients with conflictingdata and information. Additionally, information sources are generallyobscure or unknown, or may be biased or misrepresent theirqualifications or experiences. For example, users may instinctivelydistrust promotional literature about medications distributed by thepharmaceutical companies and analytical chemists who best understand acompound, yet blindly accept unfounded anecdotal stories posted byrandom, unknown strangers on the Internet, who relate only selectivefacts about their experiences and provide opinions without any apparentmedical expertise.

Even if the user overcomes the noise-to-bandwidth ratio, informationalone is not enough. Most models agree that presenting a person withinformation does not, by itself, result in habituation, althoughinformation is certainly a necessary component of education. Researchshows that, when information is taught using psychologically effectiveteaching methods, habituation is more likely to result. Verbalpresentations by an authority on the subject, for example, are far moreimpactful than reading the same information provided by the same personin writing. This is because people are fundamentally visual and socialand more easily become engaged in a verbal presentation by aninteresting authority figure. People become even further engaged inmaterial that includes an “audience participation” element whereby theviewer becomes a part of the presentation, such as by interacting insome fashion with the presenter. Active engagement increases memory andretention and lays the groundwork for later recall and application, asthe person's visual memory of the educational experience provides a moredirect mental pathway to a similar scenario encountered later than doesrecollection of written materials.

Prior art attempts to habituate good health practices have fallen shortfor a number of reasons. First, teaching and practicing good health carehabits using a live instructor is time-consuming and expensive. For one,a live instructor has a limited amount of time during the day to providesuch instruction. Also, the patient must schedule time with theinstructor in advance. The hassle of scheduling and making appointmentsalone discourages many patients from taking advantage of the opportunityto work with a live instructor. Additionally, many patients cannoteasily travel to an instruction center in the first place. This may bedue to limited physical mobility or lack of access to reliabletransportation.

Additionally, providers are often overworked and running late, andpatients often simply do not wish to schedule an appointment only to sitin a waiting room, sometimes for hours beyond the scheduled appointmenttime, waiting for their turn. Live instruction also typically imposes acost or premium, which, in the modern era, is rarely covered entirely byhealth insurance. This imposes a concrete financial cost on the patient,particularly working adults, who may see no benefit to spending goodmoney on receiving instruction on health care habits. Further,scheduling an appointment for instruction with a live instructorrequires that the appointment be held at a time when the instructor isavailable. For working people in particular, it may be difficult toschedule a time during regular business hours to get away from work, butmost live instructors are not likely to be available before or afterbusiness hours. Add in the lost time in traveling to the medical office,waiting one's turn, and traveling back, and the total time required toacquire basic instruction on medical care can constitute a substantialpart of the day. For busy working professionals, this cost often vastlyoutweighs the perceived value of the instruction. For hourly workers,this time off may simply be unavailable.

Prior art attempts to deal with these shortcomings have also fallenshort because they do not address all of these problems. For example,virtual medicine or “telemedicine” suffers many of the same problems inthat these technologies still require a live instructor, still requirethat the instructor be available at the same time as the patient, andstill require scheduling. This presents the same scheduling conflictsand time management conflicts as conventional live instruction. If“telemedicine” presentations are recorded for later viewing instead, theinteractive aspect is lost, as the patient is essentially watching avideo and has no opportunity to participate or engage meaningfully withthe instructor.

In addition to the shortcomings of using an instructor, it is virtuallyimpossible to monitor compliance. That is, doctors may simply provideliterature or links to websites with information that the patient canview, or even interactive programs the patient can complete, but thereis no effective way to monitor compliance with this program. When thepatient returns to the doctor, and the doctor asks whether the patienthas complied with the medical instructions, the patient can simply sayyes and the doctor has no way of knowing whether the patient hascomplied or not. The doctor simply must take the patient at his word, asthere is no practical way to verify the information provided by thepatient. Also, although such materials have the advantage of notrequiring a live instructor and thus having more flexibility to thepatient for scheduling and convenience, these pre-printed materials arenot customized in any way to the patient, and thus are likely to containinformation that does not apply to a given patient. Such materials alsolack the element of interactivity and engagement.

In addition to the shortcomings documented above, all of the prior artmaterials suffer the same problem of being non-habit forming. At a highlevel, the purpose of instruction and education is for the patient tohabituate good health care practices. However, one-off instruction witha nurse or doctor is unlikely to result in long-term habituation of goodhealth care habits or new routines. Further, a patient being handed aninformation pamphlet or directed to a website is also not likely toresult in long-term habituation of good habits or new routines. This isbecause these prior art techniques lack various key elements to humanbehavior change, such as gratification, positive reinforcement, and,perhaps most importantly, repetition.

Current educational practices in the health care industry continue tolag behind. Medications are distributed with literature pamphlets thatare simply thrown away, and patients often do not understand therelationship between a diagnosis and a therapy. What is needed in theart are systems and methods for providing health care instruction andeducation to patients which combine the customizability andreinforcement of a live instructor with the convenience and flexibilityof paper materials.

SUMMARY

The following is a summary of the invention in order to provide a basicunderstanding of some aspects of the invention. This summary is notintended to identify key or critical elements of the invention or todelineate the scope of the invention. The sole purpose of this sectionis to present some concepts of the invention in a simplified form as aprelude to the more detailed description that is presented later.

Because of these and other problems in the art, described herein, amongother things, is a method for practicing a health care procedurecomprising: providing a server computer comprising: a non-transitorycomputer-readable storage medium having thereon a plurality of casepackages, each of the case packages having an associated uniqueidentifier and comprising a plurality of displays for practicing ahealth care procedure, the health care procedure including a pluralityof steps to be performed in a predefined sequence, and each one of thedisplays corresponding to one of the plurality of steps, wherein eachdisplay in the plurality of displays includes at least one completioncondition required to be completed for advancement through each display;providing a client device in communication with the server computer, theclient device having a user input means and a screen, and anon-transitory computer-readable storage medium containing simulatorsoftware configured to execute any case package in the plurality of casepackages; receiving at the server computer a request comprising areceived identifier associated with one case package in the plurality ofcase packages; the server computer selecting from the plurality of casepackages a selected case package having an associated unique identifiercorresponding to the received identifier; receiving at the clientcomputer the selected case package; the simulator software on the clientdevice causing to be displayed on the screen a first display of theplurality of displays of the selected case package; via the input means,a user completing the completion condition of the first display by theuser manipulating the first display in a manner mimicking theperformance of the step of the health care procedure corresponding tothe first display; only after the user completing the completioncondition, displaying on the screen a next display in the plurality ofdisplays.

In an embodiment of the method, at least one display comprises a visualelement.

In a further embodiment of the method, the static image is selected fromthe group consisting of: a domestic setting; a hospital setting; alaboratory setting; and a clinical setting.

In a further embodiment of the method, the visual element is a staticimage of a domestic setting.

In a further embodiment of the method, the domestic setting is theuser's domicile.

In a further embodiment of the method, at least one completion conditionof the least one display comprises manipulating the visual element viathe input means.

In a further embodiment of the method, the corresponding step of thehealth care procedure for the at least one display includes the use of amedical device; the visual element comprises an image of the medicaldevice used in the corresponding step; the at least one completioncondition comprises manipulating the visual image of the medical devicein a manner mimicking the use of the medical device in the correspondingstep.

In a further embodiment of the method, the image of a medical device isan image of the same type of medical device prescribed to the user.

In a further embodiment of the method, the image of a medical device isan image of the same model of the medical device prescribed to the user.

In a further embodiment of the method, the visual element is a bodypart.

In a further embodiment of the method, the client device comprises userprofile data including the age, sex, and ethnicity of the user, and thevisual element is a graphical representation of a body party customizedto correspond to the age, sex, and ethnicity indicated in the profiledata.

In a further embodiment of the method, the visual element is aphotograph of the body part of the user.

In a further embodiment of the method, the corresponding step of thehealth care for the at least one display requires the use of a medicaldevice on the body part; the visual element of a body part is a firstvisual element; the at least one display comprises a second visualelement comprising an image of the medical device used on the body partyin the corresponding step; the at least one completion condition of theat last one display comprises manipulating the image of the medicaldevice with respect to the first visual element in a manner mimickingthe use of the medical device on the body part in the correspondingstep.

In a further embodiment of the method, the visual element is aphotograph of a friend, relative, or neighbor of the user.

In a further embodiment of the method, the health care procedure isselected from the group consisting of: a diagnostic test; a preventativeprocedure; a physical therapy; an occupational therapy; and apharmaceutical therapy.

In a further embodiment of the method, the client device communicateswith the server computer via a telecommunications network.

In a further embodiment of the method, the method further comprises: foreach display in the plurality of displays, via the input means, the usercompleting the at least one completion condition of the each display bythe user manipulating each display in a manner mimicking the performanceof the step of the health care procedure corresponding to each display;only after the user completing the at least one completion condition forall displays in the plurality of displays for the selected case package,receiving at the server computer an indication that the selected casepackage is complete.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 provides a schematic diagram of a computer network system in anembodiment of the systems and methods.

FIGS. 2A-2G provide screen shots from a computer end-user applicationimplementing an embodiment of the systems and methods.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENT(S)

The following detailed description and disclosure illustrates by way ofexample and not by way of limitation. This description will clearlyenable one skilled in the art to make and use the disclosed systems andmethods, and describes several embodiments, adaptations, variations,alternatives and uses of the disclosed systems and methods. As variouschanges could be made in the above constructions without departing fromthe scope of the disclosures, it is intended that all matter containedin the description or shown in the accompanying drawings shall beinterpreted as illustrative and not in a limiting sense.

Generally, described herein are computer-implemented systems and methodsfor self-guided education in various aspects of health care. Thedescribed systems and methods effect behavior change through afunctional relationship between the content of the educational cases,the user interaction required to compete the courses, and thesought-after behavior change.

Throughout this disclosure, the term “computer” describes hardware whichgenerally implements functionality provided by digital computingtechnology, particularly computing functionality associated withmicroprocessors. The term “computer” is not intended to be limited toany specific type of computing device, but is intended to be inclusiveof all computational devices including, but not limited to: processingdevices, microprocessors, personal computers, desktop computers, laptopcomputers, workstations, terminals, servers, clients, portablecomputers, handheld computers, cell phones, mobile phones, smart phones,tablet computers, server farms, hardware appliances, minicomputers,mainframe computers, video game consoles, handheld video game products,and wearable computing devices including but not limited to eyewear,wristwear, pendants, fabrics, and clip-on devices.

As used herein, a “computer” is necessarily an abstraction of thefunctionality provided by a single computer device outfitted with thehardware and accessories typical of computers in a particular role. Byway of example and not limitation, the term “computer” in reference to alaptop computer would be understood by one of ordinary skill in the artto include the functionality provided by pointer-based input devices,such as a mouse or track pad, whereas the term “computer” used inreference to an enterprise-class server would be understood by one ofordinary skill in the art to include the functionality provided byredundant systems, such as RAID drives and dual power supplies.

It is also well known to those of ordinary skill in the art that thefunctionality of a single computer may be distributed across a number ofindividual machines. This distribution may be functional (as wherespecific machines perform specific tasks) or balanced (as where eachmachine is capable of performing most or all functions of any othermachine and is assigned tasks based on its available resources at apoint in time). Thus, the term “computer” as used herein, can refer to asingle, standalone, self-contained device or to a plurality of machinesworking together or independently, including without limitation: anetwork server farm, “cloud” computing system, software-as-a-service, orother distributed or collaborative computer networks.

Those of ordinary skill in the art also appreciate that some deviceswhich are not conventionally thought of as “computers” neverthelessexhibit the characteristics of a “computer” in certain contexts. Wheresuch a device is performing the functions of a “computer” as describedherein, the term “computer” includes such devices to that extent.Devices of this type include but are not limited to: network hardware,print servers, file servers, NAS and SAN, load balancers, and any otherhardware capable of interacting with the systems and methods describedherein in the matter of a conventional “computer.”

Throughout this disclosure, the term “software” refers to code objects,program logic, command structures, data structures and definitions,source code, executable and/or binary files, machine code, object code,compiled libraries, implementations, algorithms, libraries, or anyinstruction or set of instructions capable of being executed by acomputer processor, or capable of being converted into a form capable ofbeing executed by a computer processor, including without limitationvirtual processors, or by the use of run-time environments, virtualmachines, and/or interpreters. Those of ordinary skill in the artrecognize that software can be wired or embedded into hardware,including without limitation onto a microchip, and still be considered“software” within the meaning of this disclosure. For purposes of thisdisclosure, software includes without limitation: instructions stored orstorable in RAM, ROM, flash memory BIOS, CMOS, mother and daughter boardcircuitry, hardware controllers, USB controllers or hosts, peripheraldevices and controllers, video cards, audio controllers, network cards,Bluetooth® and other wireless communication devices, virtual memory,storage devices and associated controllers, firmware, and devicedrivers. The systems and methods described here are contemplated to usecomputers and computer software typically stored in a computer- ormachine-readable storage medium or memory.

Throughout this disclosure, terms used herein to describe or referencemedia holding software, including without limitation terms such as“media,” “storage media,” and “memory,” may include or excludetransitory media such as signals and carrier waves.

Throughout this disclosure, the term “network” generally refers to avoice, data, or other telecommunications network over which computerscommunicate with each other. The term “server” generally refers to acomputer providing a service over a network, and a “client” generallyrefers to a computer accessing or using a service provided by a serverover a network. Those having ordinary skill in the art will appreciatethat the terms “server” and “client” may refer to hardware, software,and/or a combination of hardware and software, depending on context.Those having ordinary skill in the art will further appreciate that theterms “server” and “client” may refer to endpoints of a networkcommunication or network connection, including but not necessarilylimited to a network socket connection. Those having ordinary skill inthe art will further appreciate that a “server” may comprise a pluralityof software and/or hardware servers delivering a service or set ofservices. Those having ordinary skill in the art will further appreciatethat the term “host” may, in noun form, refer to an endpoint of anetwork communication or network (e.g., “a remote host”), or may, inverb form, refer to a server providing a service over a network (e.g.,“hosts a website”), or an access point for a service over a network.

Throughout this disclosure, the term “cloud” and “cloud computing” andsimilar terms refers to the practice of using a network of remoteservers hosted and accessed over the Internet to store, manage, andprocess data, rather than local servers or personal computers.

Throughout this disclosure, the terms “case” or “course” and“educational case” or “educational course,” sometimes used in connectionwith the term “package” (as in, a “case package”) refers to aneducational software package implementing the delivery to a user ofcertain specific audiovisual content, the content being designed andpresented to use habituate good health care practices in a usercompleting the case or course. The cases are generally multi-stepserialized prompts requiring the user to interact with visual oraudiovisual elements presented in the case in order to complete or solvethe case. The cases may comprise still imagery, video, audio, and otherinteractive elements that can be manipulated by the user. The case isgenerally comprised of a plurality of displays shown to the user on ascreen of a device, in a pre-defined sequence, and each display containsone or more completion conditions which must be completed in accordancewith a health care procedure to be practiced. Completing all of thecompletion conditions on all screens in a case completes or “solves” thecase.

A “completion condition” as used herein generally means any manner ofusing the input means of a computer device to manipulate the audiovisualor other interface components of a case display in a manner that mimicshow the corresponding step of a health care procedure to be performedwould be carried out in the real world. The term “mimic” and itsderivatives, as used herein, means manipulation of the elements of adisplay in the simulation software, the manipulation requiring physicalmovement by the user that mirrors, copies, or replicates the physicalmovements or activities involved in performing the corresponding healthcare procedure in real life.

By way of non-limiting example, this may be as simple as using a mouseor touchscreen to drag an image of a closed first into contact withanother fist, thereby causing a “fist bump” and practicing good handhygiene. Also by way of non-limiting example, if the real-life procedurerequires an insulin bottle to be inverted ten times, then the mimickingwould involve manipulating the display to cause an image of an insulinbottle to be inverted ten times in the display. By way of clarification,this should be understood as distinct from clicking an interface buttonor otherwise interacting with the interface in a manner that indicates“completion” of the display but does not involve the use of the inputmeans in a fashion that involves physically motion mirroring ormimicking the physical motions required in the corresponding real-lifehealth care procedure.

The term “display,” as used herein, generally refers to an interactiveaudiovisual presentation able to be shown to a user via a screen orother output means. A case package typically comprises a plurality ofdisplays.

FIG. 1 depicts an embodiment of a system and method according to thepresent disclosure. The depicted embodiment comprises a user device(103) communicably coupled to a database (105) over a network. Thedatabase (105) is generally housed in a server computer (109). The userdevice (103) is also communicably coupled to a cloud computing platform(107). The server computer (109) may also be a physical, virtual, orlogical computer in a cloud computing platform, which may be the samecloud computing platform (107). From an implementation standpoint,however, the server computer (109) is logically distinct from the cloudplatform (107). Likewise, one of ordinary skill in the art willunderstand that “cloud computing” simply means remote hosting, and thecloud computing platform may be substituted with one or more localservers serving the same function in the system.

These systems implement a software distribution framework that is user-and/or group-specific, and which ultimately delivers a software packageto the user device (103). The software package comprises instructionsfor running one or more short educational cases or courses on the userdevice (103). These cases are generally interactive, requiring the userto undertake specific, concrete interactions with the interface in orderto complete the case. The interactions are themselves designed tohabituate good health care practices in the user, and generally mirrorthe desired behavior changes.

Because behavior change is not unifactorial, each educational casegenerally embeds a plurality of drivers or techniques. These aregenerally aspects of the content and/or user interactions that mayinduce desired compliance in the user. Each individual user may respondto different combinations of drivers, and some may respond to none.Thus, the purpose of the system is not necessarily to cause any oneparticular user to change his/her behavior, but rather to influence astatistically significant subset of a larger group of users.

For example, a health insurer may offer policies at a reduced premium toall policyholders who complete a particular package of educationalcases. Even if a relatively small percentage of those who complete thepackage ultimately adopt the desired behavior changes, this small amountof behavior change may still significantly reduce insured care, therebyoffsetting the reduction in premiums. In other words, the change inbehavior may be statistically significant compared to the overall scaleand cost of health care services to justify a premium offset from anincentive standpoint. The benefits of these behavior changes includepolicyholders who are healthier and miss less time at their jobs andwith their families, as well as a reduction in the quantity of healthcare services demanded, applying downward pressure on costs andresulting in fewer insured claims.

Generally, each case or course implements one or more drivers. In thepreferred embodiment, each such driver is selected from the followingsix primary drivers: consistency; reciprocity; authority; consensus;scarcity; and positive regard. Other drivers may additionally oralternatively be implemented as well, but this disclosure focuses onthese six drivers for sake of simplicity.

Consistency refers to the general human desire for consistency betweenword and deed. When humans say one thing but do another, they tend toexperience a negative psychological response, often in the form oftension or anxiety. However, acting consistently with one's word tendsto result in a positive psychological response. When a person says aloudthat he or she will do something, that person is more likely to do itand may even change behavior to comply with his or her own verbalstatement, even if the person has not promised or firmly committed toperforming the stated action. This principle also works when one personsays aloud an expected behavior from another person. For example, whenPerson A performs a favor for Person B and Person B thanks Person A,Person A may respond with, “You would have done the same for me.”Because Person B has stated aloud a future behavior expectation fromPerson A, Person A generally experiences a psychological desire, tovarying degrees depending on the individual, to conform future behaviorin accord with this stated expectation.

Reciprocity refers to the principle of social psychology holding thatindividuals tend to “pay back” in kind what is received from others.Gift-giving is a common example. When Person A receives a gift fromPerson B on his or her birthday, Person A feels a social obligation toprovide a gift to Person B on Person B's birthday. This sense of futureobligation and social exchange is often the foundation of relationships,as those who consistently fail to exhibit reciprocity are perceived asfree riders and often ostracized from groups. Continuing the aboveexample, when Person A says, “You would have done the same for me,”Person A is both setting up an expectation of future behavior with whichPerson B feels compelled to act consistently, and Person A is alsoreinforcing the principle of reciprocity, causing Person B to recognizea social debt owed and further inducing Person B to repay that debt.Because this is also consistent with the stated expectation of futurebehavior, Person B has two psychological drivers towards behaviorchange.

Authority refers to the human tendency to obey perceived authorityfigures, whether or not those figures have any obvious means ofenforcing their instructions. So ingrained is the willingness to obeyinstructions that people can, in surprisingly large numbers, be inducedto undertake behaviors that conflict with their personal conscience ormoral code, the perhaps most famous example being the Milgramexperiment. Common badges of authority figures include dress andcarriage, as recognizable uniforms (e.g., lab coats for doctors) are aquick and effective visual cue to establish the identity and credibilityof an authority figure, and a likable, confident carriage likewiseinduces a desire for compliance and obedience.

Consensus refers to the human desire to behave consistently with a peergroup with which an individual identifies, and, conversely, to sometimesbehave inconsistently with groups with which the individual does notidentify. Related to the concepts of peer influence and peer pressure,consensus is a powerful influencer of behavior change, as any oneindividual can readily perceive the collective behavior of others butcannot definitively understand the thought process motivating thosebehaviors in each individual. The individual is thus generally inducedto mimic the consensus behavior to avoid “sticking out” as unusual ornon-compliant with a perceptible norm.

Scarcity refers to the human tendency to attribute inflated value tothat which is rare or difficult to obtain over that which is abundant,and to desire to have access and control over same. Perhaps the simplestexample of this driver is “Black Friday” shopping, which inducesmillions to camp out in retail shopping centers overnight to compete forcoveted “deals.” Capitalizing on this psychological phenomenon is avenerable sales tactic, as many buyers can be induced to make a decisionto purchase immediately (i.e., change behavior) for fear of missing outon a good deal or missing out on the opportunity to possess the scarceitem at all.

Finally, positive regard refers to general likability of the personsuggesting a behavior change. Those who are positive, complimentary,happy, and cooperative can induce a desire for compliance among others.

One or more of these drivers is implemented via each case. Importantly,the driver is generally represented either through audiovisualcomponents of the case, interface components, or both. The behaviorchange is sought to be induced by virtue of practicing a health careprocedure with the assistance of computer software providing asimulation of the procedure to be performed. This may be best understoodthrough reference to an example.

FIG. 2A depicts a case package (201) displayed on a user device (103).The depicted case package (201) concerns diabetic care and implementsseveral behavior change drivers. A background image (203) is included inthe case (201), depicting a cozy domestic setting. This is a subtlevisual cue to the user that the behavior practiced in the case (201) isa behavior performed at home. In a preferred embodiment, the backgroundimage (203) is an image of the specific patient's own home, furtherreinforcing the location of the behavior, as human memory has been shownto have a strong location correlation component. Where the image is ofthe specific user's own home, the image may be captured by the userdevice (103) and uploaded, processed, stored, and packaged into the casefor the specific user as described elsewhere herein. That is, althoughthe same basic case is presented to multiple users, each user canreceive a customized version with imagery specific to that user toreinforce the induced behavior change.

Also shown in FIG. 2A is a video playback component (205) depicting anauthority FIG. (207) in a suitable environment (209). The depictedauthority FIG. 207 ) is a pharmacist wearing a conventional pharmacistuniform. These elements implement a behavior change driver—authority—andreinforce it by depicting the authority FIG. 207 ) in a recognizableuniform, and providing information in an audiovisual format via anembedded video (205), while having the authority FIG. 207 ) depicted ina clinical or medical setting, further reinforcing the importance andcharacter of the information conveyed. The specific content provided bythe authority FIG. (207) is functionally tied to the behavior changedesired, as well as to the content of the video, to the extent of atleast the presence and appearance of the authority FIG. 207 ) andauthority environment (209). Thus, the overall user experience in thecase (201) presented in FIG. 2A is of an authority FIG. 207 ) in anauthority setting (209) coming into the user's home via the backgroundimage (203) to provide medical information.

Referring now to FIG. 2B, different behavior change drivers areimplemented. The background image (203) remains, but the authorityfigure video component (205) is now replaced by a static image of amedical device (215) pertaining to the procedure being taught—in thiscase, how to use a blood glucose lancing pen for diabetics. The depictedmedical device (215) is a generic blood sugar lancing pen (215), but ina preferred embodiment, the user's own specific brand of lancing pen(215) is depicted. This may be done by associating an image of theuser's specific pen (215) when the pen or prescribed or purchased, asdescribed elsewhere herein. Depicting the user's specific device (215)further reinforces the induced behavior change.

In the depicted embodiment of FIG. 2B, the user is provided a briefwritten instruction (219) concerning how to proceed with the case (201).In the depicted embodiment, the instructions (219) tell the user toremove the lancing device cap (217) by clicking a user interface element(213), in this case, an arrow (213). The user does this by manipulatinga user interface device (111), such as a mouse (111), keyboard (111), ortouch screen (111) in the conventional fashion. Alternatively, the usermay be asked to use the interface to select the cap (217) and slide itaway from the pen (215) to remove it. In either case, in response to theuser input, the image (215) changes to an animation to show the capbeing removed (211). This part of the case (201) is thus solved and theuser is presented with the next phase of the case (201).

In FIG. 2C, the same basic interface is depicted, except that anothercomponent of the medical device (215) appears. In this embodiment, thecomponent is a lancet drum, used to install a lancet in the pen. Again,the user manipulates the interface in a similar manner as in FIG. 2B,except in this case the user is installing a lancet in the pen (215) viaa lancet drum (221). Again, it is preferred that the depicted drum (221)correspond to the equipment used by the specific user performing thecase (201). In FIG. 2D, the same basic interface is depicted, exceptthat the user is now asked to replace the lancet cap (217) on the pen(215). Again, the user manipulates the interface in a similar manner asin FIGS. 2B and 2C, this time replacing the cap (217) on the pen (215).The pen (215) is now ready to be used to draw blood.

FIG. 2E depicts the next step, now showing a blood glucose testingdevice (223) and a blood glucose testing strip (225). Diabetics use onesuch strip each time they test blood sugar levels, and the strip (225)is inserted into a socket on the machine (223). Then a drop of blood isplaced on an inlet of the strip (225), and the device then automaticallydraws the blood in and determines the blood sugar level, which is thenreported on the device's display. In the depicted embodiment of FIG. 2E,the user is asked via the instructions (219) to drag the depicted teststrip (225) to a specific location (227) on the blood sugar testing kit(223) to simulate placing a real strip in a real kit. As with the priorexamples, it is preferred that the depicted device (223) and strip (225)be the same model and brand used by the specific user. In this part ofthe case (201), the user manipulates the interface to drag the strip(225) to the appropriate location, helping the user understand where onthe device (223) the strip is to be inserted, and a visual cue is givenvia a highlighted or emphasized section (227) of the interface.

In the depicted embodiment of FIG. 2F, the user is instructed to lancethe hand to draw blood. Diabetics are generally advised to lance theside of a finger. This is because repeated strikes can kill nerveendings, and the sides of fingers have both plentiful blood supply andreduced nerve density, lowering the chances of nerve damage and alsoreducing the discomfort to the patient. The pen (215), now prepared fromprior steps, is depicted, along with a hand (229) and an emphasized orhighlighted area (227) showing where to place the pen (215) to lance thefinger. The user again manipulates the interface to drag the pen (215)to the appropriate position. Again, an image of the user's own hand(229) and pen (227) is preferred.

Finally, in the depicted embodiment of FIG. 2G, the case (201) concludeswith the blood glucose test. The interface depicts the blood sugartesting device (223), now loaded with a testing strip (225), and thehand (229), now with a spot of blood (231) from the lancing pen (215) inthe prior step. A highlighted or emphasized portion (227) provides avisual cue of where to move the testing device (223) to pick up theblood (231) and begin the test. The user again manipulates the interfaceto drag the testing kit (223) to the appropriate position (227),completing the case (201).

In an embodiment, the user is then prompted to take an action based onthe blood glucose value (or, in embodiments using other cases, otherwisetake an action based upon the results of the simulation). By way ofexample, if the blood glucose level is elevated, the user may beinstructed to take a walk, or another simulation for an insulininjection may be shown. Alternatively, the user may not be provided anyspecific instruction, but rather given a multiple choice series ofoptions and must select the most appropriate action that should betaken. The method thus develops critical thinking skills to habituategood health care practices.

Finally, at the conclusion of the case, the user may then be providedwith a closing video or other congratulatory reward, which provides animmediate feedback mechanism confirming that the user has performed thesteps correctly.

It should be noted that, although the user generally manipulates thecomputer in the conventional fashion by interacting with graphicalelements of an interface using input means or devices (111), the purposediffers in that the software is not designed to allow the user tocontrol and manipulate the computer, but rather the software is designedto control and manipulate the user. That is, the user is using thesoftware for the sole purpose of practicing steps that the user isexpected to take in the real, practical world. The software itselfserves no particular application purpose with respect to the computeritself. The software is not mere “how-to” software providing multimediainstructions, but rather is an interactive educational package whichrequires the user to fully simulate the behaviors sought, in properorder, without shortcuts. This reinforces the entire behavior to theuser and frames the user's perception of the steps involved and theamount of time they take.

Thus, when the user is later performing the steps in the real world andit has taken only a few minutes, the user can be confident that he orshe has performed the steps correctly because the simulation took only afew minutes and included all of the same steps. It also reinforces tothe user that uncomfortable or difficult actions are acceptable andcorrect. For example, many people are averse to drawing blood, but thesimulation shows this as a normal part of the testing process,reinforcing to the user that doing so is a normal part of the healthcare routine. This may help some users overcome cognitive biases thatmight otherwise overwhelm their decision-making and cause them toabandon the process and discontinue attempting to monitor blood sugarlevels, finding it too difficult, inconvenient, uncomfortable, oranxiety-inducing.

The cases (201) can also reinforce to users the normalcy in performingcertain activities, particularly tedious or repetitive procedures. Forexample, Type I diabetics generally take two types of insulininjections, one long-term acting and one short-term acting, and theseare usually mixed before injection. Proper mixing usually requires thatthe pen be inverted ten times. A simulation of how to load the pen withinsulin would thus require the user to invert the digital version of thepen ten times, simulating the real-life scenario, even though the userhas obviously understood how to manipulate the interface to invert thepen after one try. The requirement to invert ten times is not imposedbecause the user's interaction with the interface serves any computerapplication purpose; rather, the user goes through the exercise ofinverting the digital pen ten times to induce and reinforce the desiredbehavior of inverting a real pen ten times before applying theinjection.

As described above, the cases (201) are generally specific to a givenbehavior change that is desired. That is, a given case (201) may be forteaching a user how to use a diabetic lancing pen and blood glucosetesting kit, but the case, when presented to a specific user, mayinclude customizations for that specific user. Preferably, thesecustomizations further induce the desired behavior. These are generallydescribed above and generally comprise replacing generic components ofthe case (201) with user-specific components, such as background imageryof the user's own home or office, or of the user's physician's office,or another location appropriate for the case (201). Other customizationsmay include images of the user or the user's friends, family, orcaregivers, and of the user's own medical equipment. Thesecustomizations may be added to system at virtually any point in thehealth care process, or by the user directly when using the end-usersoftware as described elsewhere herein.

The content of the cases generally presents a scenario related to amedical condition of the user as well as a problem to be solved via auser action or interaction with the interface elements of the presentedscenario. The scenario is not completed until the user performs allrequired actions and performs them in the correct manner, according tohow the scenario is architected and programmed. This aspect is importantbecause the scenario may be sponsored or required by a third party,which has an interest in the user completing the scenario correctly,such as a doctor, insurer, family member, caregiver, or even the user.

The completion aspect further appeals to other aspects of compliance,many of which are well-documented in gamification research, notablyachievement and advancement. Again, the completion steps mirrorreal-world scenarios that the user will encounter in connection with amedical condition, thus reinforcing the desired behavior. This has theadvantages of convenience and verifiability, as the user can completethe case at any time from his own home without having to schedule anappointment or meet with anyone, and because the system is computerized,the potential for falsely self-reporting completion is reduced.

It is also important to understand that the visual and interactiveelements of the case displays are not arbitrary, but rather bear afunctional relationship to the real-world health care procedure beingtaught. If the content of the cases were changed to vary from theprocedure, the cases would be less effective and, if changedsufficiently, completely ineffective.

An example may further illustrate the typical structure of a set ofcases. Continuing with the example of diabetic care, non-compliance withmedications and/or regular blood glucose measuring are known to besignificant contributing factors to poor blood sugar control, resultingin diabetic complications that impose costs on both the health caresystem and society at large. Thus, a physician, insurer, or otherinterested party may provide a reward or incentive for all thosepatients in a given group who complete a specific set of cases using thesystem and methods described herein. Typically, the user is presentedwith a plurality of cases concerning the same concept or behavior, asrepetition is known to be a major factor in compliance.

Turning now to FIG. 1 , the hardware systems used to implement thistechnology are depicted. The major depicted components are an end-userdevice (103), a server computer (109), a database system (105), a cloudcomputing service or platform (107), and a third party computer (113).Conceptually, the cases are delivered through a framework comprisingcase building software (115) and simulator software (117).

The end-user device (103) is typically a smart phone, tablet, or othercomputing device, having a user input means (111) operatively connectedthereto. One of ordinary skill in the art will understand that an inputmeans (111) is any user input device configured to provide input to thecomputer user. Examples of such devices include, but are not limited to:pointing devices (111) such as a mouse, trackpad, trackball, joystick,pointing stick, and the like; keyboard (111); tactile and/ortouch-screen interface (111); audio input device, such as a microphone;motion-sensor, such as an accelerometer, gyroscope, or three-dimensionalscanner; and composition devices using two or more of these or othertechnologies. The user device (103) generally also has a display means,such as a built-in display, attached monitor, projector, or other outputmechanism known in the art. The end-user software includes simulatorsoftware generally installed on the end-user device (103), but thissoftware may alternatively be accessible via a web site or othercommonly distributed application delivery framework. The cases (201) aregenerally stored in a database (105) accessible by the user device (103)over a network. In the depicted embodiment, the cases (201) are built orconstructed by a software program executing on a computer, generally thethird party computer (113), but one of ordinary skill will understandthat any computer in the system with appropriate hardware, includingcomputer systems not depicted. The user device (103) may also bereferred to as the client or client device herein.

When a new user first uses the system, the user creates, or is assigned,authentication credentials. These are preferably stored independentlyfrom the cases. In the depicted embodiment of FIG. 1 , a cloud service(107) hosts user-specific data, such as authentication credentials, andmanages the authentication process. That is, when a user loads thesimulator software on the user device (103), the simulator connects overa network to an authentication system in the cloud (107). If the user isauthenticated, the authentication system may return one or more tokens,cookies, or other identifiers indicating a set of one or more cases(201) in the database (105) for the user. These specific cases (201) maybe associated with the user for any number of reasons.

In an embodiment, the system may have, or have access to, demographicdata about the user, and cases may be selected for the user based uponsuch demographic data. Factors such as age, sex, ethnicity, religion,and country of origin may influence which cases (201) are presented, ascertain diseases and conditions are more common among members ofspecific demographic groups.

In an embodiment, a case is associated with a user in connection withthe provision of health care services. For example, a diabetic patientvisiting an endocrinologist may be prescribed a new blood glucose meterand testing strips. At the point of diagnoses and prescription, thesystem may be updated by the physician or his/her staff via a physicianclient computing device (not depicted), which again may be anything froma smart phone or tablet to a desktop computer. Cases for diabetes maythus be associated with the user, and those cases may be automaticallycustomized for the user, based upon the specific glucose meterprescribed.

Cases may be prescribed based upon a set of cases selected by thedoctor, or by somebody else, such as the insurer. Cases may also bespecific to the medication or devices or therapies prescribed, and thusmay also be selected, at least in part, based upon the recommendationsof a device manufacturer, therapist, or pharmaceutical manufacturer.Cases may also be selected based upon specific aspects of the patient,or may be recommended based upon the patient's medical history, or by afriend, family member, or other caregiver.

An aspect of the systems and methods described herein is effectivelyinfinite customized ability. This customized ability comes primarily,but not exclusively, in the form of customizing the appearance of thevarious aspects of the cases to match, as closely as possible, theday-to-day life and environment of the patient. By way of example, andnot limitation, as described elsewhere herein, where a case depicts abackground photograph, such as a domestic setting, a photograph of thepatient's own home may be substituted for stock photography. Similarly,still photography of an authority figure, such as a pharmacist orphysician, may be replaced by a photograph of the patient's own primarycare physician, or another doctor or caregiver. Also by way of exampleand not limitation, photographs of the medical devices or medicinestaken by the patient may be substituted for the specific devices ormedicines taken by the specific patient.

Further customizations are also specifically contemplated. Such furthercustomizations may include aspects such as altering the skin tone ofelements of the simulation intended to represent the patient to matchthe patient's own coloration. Similarly, the apparent age of a depictedelement intended to represent the patient may also be altered to matchthat of the patient. Thus, where the simulation would depict, forexample, a finger being pricked to draw blood, the appearance of thehand may be altered to match the age and pigmentation of the user. Thiscould be done based on a provided photograph of the user, or based upondemographic information provided to the system, which could be used as aproxy. For example, if the patient is indicated as being a Caucasian inher 70's, the depicted hand may be pigmented generally as a Caucasian,with age lines, and perhaps fingernail polish or longer fingernails,indicating a female hand. By contrast, where the patient is a youngblack male, the pigmentation may be darker, and the hand may appearyounger, and lack adornment.

Further customizations may be possible, such as including messages fromfriends or family members to reinforce the habituation of the desiredhealth care practices. For example, an image of a parent may appear foryounger users, or of a child for older users, providing customizedmessages from the family member, and may possibly include an image ofthe family member, further reinforcing the desired habit. The simulationthus has the advantages of a live instructor in that the experience iscustomized to the specific user, but has the convenience of standalonelessons such as paper pamphlets, which the user can consume in theconvenience of his or her own home at any time, without having toschedule an appointment or travel to a medical office. Because thesimulations are repeatable, habituation is more likely, and compliancecan be confirmed and monitored through the use of computer software.Techniques for doing so are well known in the art, as the completion ofa lesson can simply be communicated to a server system and stored inmemory for later access by a party desiring to monitor or confirm thecompliance with the lessons.

Referencing again to the depicted embodiment of FIG. 1 , individualusers are generally managed on the server side through a uniqueidentifier for the user associated with a set of profile data. A usermay also be associated with one or more groups, also generallyidentified via a unique identifier associated with a set of profile datafor the group. Such groups may be organized along any categorical lines,such as but not necessarily limited to demographical groups and/orcommercial groups (e.g., sets of users insured by the same carrier).This allows the system to assign appropriate courses to a user based ongroup membership. By way of example and not limitation, an insurancecarrier may offer a premium discount to all policyholders who complete agiven set of courses. All qualifying users may then be associated into agroup and, by virtue of that group membership, assigned the coursesselected by the insurance carrier.

Also, in an embodiment, certain courses may be assigned only toindividuals with certain demographic characteristics. For example,courses related to pregnancy may be assigned only to users in a“pregnancy” group. Also by way of example and not limitation, certaincourses may concern subject matter only relevant to one sex or theother, such as courses related to certain aspects of reproductivehealth. Also be way of example and not limitation, certain courses mayconcern subject matter primarily relevant to certain ethnicities, assome diseases disproportionately afflict members of certain ethnicgroups.

Referring now to FIG. 1 , cases and case data are typically stored in amemory of the computer server (109) and are provided to the user clientcomputer (103) via a network connection. The server (109) may comprise abuilder (115), which is used to construct new cases. The cases aretypically stored in a database (105), which is communicatively andoperatively connected to the server (109). Once a user has logged in(typically via the cloud (107)), a user identifier associated with theuser is retrieved from cloud (107) storage and provided to the server(109) via the client computer (103). The received user IDs at the server(109) is used to retrieve a set of applicable cases from the database(105), which are then returned to the user device (103) by the server(109). The available cases may then be displayed to the user, typicallyvia a display (111) on the user device (103). The user may thenmanipulate the user interface of the user device (103) to select thecase to be completed. The user may then select the case, which is thenloaded and displayed on the user device (103) from the database (105),and the user may complete the case as described elsewhere herein. Oncethe case is completed, an indication of same is sent to the server (109)from the user device (103), which is then recorded in a memory for laterretrieval to confirm completion and compliance.

Customization may take place at any point in this process. In thesimplest example, when a case is first downloaded to the user device(103), the case will contain generic imagery. For example, if the casedepicts a domestic setting, stock photography of an attractive middleclass household may be depicted. Similarly, if the case depicts anauthority figure, such as a doctor or pharmacist, a genericrepresentation of a doctor or pharmacist may be shown. The user maycustomize the case at that point. This may be done by, for example,using a camera or other imaging device associated with the user device(103) to capture a photograph of the user's own home. This domesticphotography may then be integrated into the case to replace the stockphotography. Additionally, the custom domestic photograph captured bythe user may be uploaded to the server (109) and stored in connectionwith the user's identifier. This photograph may then be used in allsubsequent or other cases performed by the user which utilize domesticphotography. For example, if the user later requests another case thatincludes domestic photography as a driver, the user's own prior customdomestic photograph will be downloaded instead of the stock photography.Alternatively, this customization may be stored in association with userprofile data via the cloud (107). Other photographs or customizationsmay also be inputted by the user, such as a photograph of the user, orof the user's hand or another body part, which photograph may be used tofurther customize a simulation as described elsewhere herein. By way ofexample and not limitation, these customizations may cause elements ofthe simulation which represent the user to be customized to match theuser's age, ethnicity, appearance, or other similar aspects.

Customization may also take place at the point of prescription or case.For example, when a doctor prescribes a medicine or device, the doctorcan associate the prescribed device with the patient at the doctor'soffice. Thus, when the doctor prescribes the device, and the case is tobe completed, the cases are automatically customized with the specificdevice prescribed by the doctor. This may also comprise selectingspecific cases for the specific device, as medical devices servingsimilar purposes may nevertheless have subtly different nuances in howthey operate. This has the advantage of the simulation automaticallybeing updated when the patient downloads it, without the patient havingto take any further steps. Again, this customization data may be storedin the server or in the cloud (107) in connection with the user'sidentifier.

Customization may also take place at the point of procurement, such aswhen the user acquires a pharmaceutical product from a pharmacy.Different pharmaceutical manufacturers will have different appearances,shapes, and sizes for the same medication. This can be confusing topatients who expect their medication to always appear the same way.Particularly for patients who take multiple medications, thesedifferences in medication appearances can reduce compliance or increasethe risk of overdose or misuse. Thus, since the pharmacy is aware at thepoint of procurement which specific manufacturer's medication was givento the user, the pharmacy can access the system and associate thatspecific medication with the user profile. Thus, when the user laterparticipates in a simulation case pertaining to that medication, themedication will appear in the case having the same appearance as theactual medication the user acquired at the pharmacy. This would allowtwo different patients receiving the same medication, but manufacturedby two different production lines, to each have the visual appearance ofthe medication in their cases match the actual medication each patientreceived. Because the particular mediation can even vary from pharmacyto pharmacy, or from refill to refill at the same pharmacy, thepharmacist can access the system to update the medication for thepatient with each refill, ensuring that the visual appearance of themedication in the cases remains accurate.

In embodiments involving such customizations, the customization data ispreferably stored in the cloud in association with user specificinformation. That is, the user's demographic information andcustomizations are typically stored in the cloud (107), are retrieved inconnection with user authentication, may be stored locally on the userdevice (103), and then may be integrated into a downloaded case.Alternatively, such information may be provided to the server (109) andintegrated into the case at the server (109), with the completed,customized case being downloaded back to the user device (103). However,it is generally preferred that the customization take place at the userdevice (103), reducing the number of times that user-customizedinformation is transmitted. This is particularly important to the extentthat the user customizations may include photographs of individuals, asthe user generally would prefer that such materials not be transmittedany more than is necessary. Customizations by a doctor, pharmacist, orother third party may generally be done via a third party computersystem (113), as shown in FIG. 1 .

To make and use the described systems and methods, one of ordinary skillwould use existing computer hardware and software systems and developadditional required programming to implement the simulation software andfacilitate the other operations. The computer operations required toimplement the systems and methods are known to one of ordinary skill inthe art and can be carried out using any modern programming language ordevelopment platform. The specific programming techniques and thehardware and software architectures will vary from embodiment toembodiment, depending upon, among other things, the programminglanguage(s) and development platform(s) used, as well as the hardwaresystems and end-user environment in which the systems will be used.These selections are primarily a matter of taste, preference, andresources. Any suitable platform (e.g., Windows™, MacOS™, Linux™) iscontemplated, as well as any reasonably modern programming language(e.g., Java, C++, C#).

While the invention has been disclosed in connection with certainpreferred embodiments, this should not be taken as a limitation to allof the provided details. Modifications and variations of the describedembodiments may be made without departing from the spirit and scope ofthe invention, and other embodiments should be understood to beencompassed in the present disclosure as would be understood by those ofordinary skill in the art.

1. A method for automated, computer-aided training for a medical healthcare procedure comprising: providing a server computer comprising: anon-transitory computer-readable storage medium having thereon aplurality of case packages, each said case package having an associatedunique identifier and comprising a plurality of displays for automated,computer-aided training for a medical health care procedure, saidmedical health care procedure including a plurality of steps to beperformed in a predefined sequence, and each one of said displayscorresponding to one of said plurality of steps, wherein each display insaid plurality of displays includes at least one completion conditionrequired to be completed for advancement through said each display, eachof said displays comprising a placeholder image of a domestic setting,and at least one of said displays comprising a visual representation ofa body part, said visual representation having a placeholder representedage and a placeholder represented skin pigmentation; providing a clientdevice in communication with said server computer, said client devicehaving a user input means and a screen, and a non-transitorycomputer-readable storage medium containing simulator softwareconfigured to execute any case package in said plurality of casepackages; receiving at said client device image data of a user of saidclient device; receiving at said client device image data of a domicileof said user; receiving at said server computer a request comprising areceived identifier associated with one case package in said pluralityof case packages; said server computer selecting from said plurality ofcase packages a selected case package having an associated uniqueidentifier corresponding to said received identifier; receiving at saidclient device said selected case package; said client device: modifyingsaid received case package by replacing said placeholder image of adomestic setting in each of said plurality of displays with saidreceived image data of said domicile; modifying said placeholderrepresentation of said age of said body part to correspond to the age ofsaid user based on said received image data of said user; modifying saidplaceholder representation of said skin pigmentation of said body partto correspond to the skin pigmentation of said user based on saidreceived image data of said user; said simulator software on said clientdevice causing to be displayed on said screen a first display of saidplurality of displays of said modified selected case package, said firstdisplay being a display in said at least one of said displays comprisinga visual representation of a body part, said displayed first displayincluding said image data of said domicile, and said displayedrepresentation of said age of said body part corresponding to said ageof said user based on said image data of said user, and said displayedrepresentation of said skin pigmentation of said body part correspondingto said skin pigmentation of said user based on said image data of saiduser; via said input means, said user completing said completioncondition of said first display by said user manipulating said firstdisplay in a manner mimicking the performance of said step of saidmedical health care procedure corresponding to said first display; onlyafter said user completing said completion condition, displaying on saidscreen a next display in said plurality of displays; after said usersuccessfully completes all displays in said plurality of displays, saidclient device transmitting to said server computer an indication thatsaid user has successfully completed all displays in said plurality ofdisplays; receiving at said server computer said transmitted indicationof completion; storing at said server computer said received indicationof completion; and confirming compliance by said user with saidautomated training by retrieving said stored indication of completion.2. The method of claim 1, wherein at least one completion condition ofsaid least one display comprises manipulating said visual element viasaid input means.
 3. The method of claim 2, wherein: said correspondingstep of said medical health care procedure for said at least one displayincludes the use of a medical device; said visual element comprises animage of said medical device used in said corresponding step; said atleast one completion condition comprises manipulating said visual imageof said medical device in a manner mimicking the use of said medicaldevice in said corresponding step.
 4. The method of claim 3, whereinsaid image of a medical device is an image of the same type of medicaldevice prescribed to the user.
 5. The method of claim 4, wherein saidimage of a medical device is an image of the same model of said medicaldevice prescribed to the user.
 6. The method of claim 1, wherein saidmedical health care procedure is selected from the group consisting of:a diagnostic test; a preventative procedure; a physical therapy; anoccupational therapy; and a pharmaceutical therapy.
 7. The method ofclaim 1, wherein said client device communicates with said servercomputer via a telecommunications network.